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09-03-2023 | Vestibular Schwannoma | Research

Using the deformity index of vital structures to predict outcome of patients with large vestibular schwannomas after Gamma Knife radiosurgery

Authors: Hao-Chun Chang, Weir Chiang You, Chiung-Chyi Shen, Ying Ju Chen, Ming-His Sun, Meei-Ling Sheu, Liang-Yi Pan, Jason Sheehan, Kuo-Chih Su, Hung-Chuan Pan

Published in: Journal of Neuro-Oncology | Issue 1/2023

Abstract

Purpose

Microsurgery is the mainstay of treatment for large vestibular schwannomas (VS), but the benefits of radiosurgery remain incompletely defined. Here, we aim to use automated volumetric analysis software to quantify the degree of brain stem deformity to predict long-term outcomes of patients with large VS following GKRS.

Methods

Between 2003 and 2020, 39 patients with large VS (volume > 8 cc) undergoing GKRS with a margin dose of 10–12 Gy were analyzed. The reconstruction 3D MRI was used to evaluate the extent of deformity for predicting the long-term outcome of patients.

Results

Their mean tumor volume was 13.7 ± 6.3 cc, and their mean follow-up after GKRS was 86.7 ± 65.3 months. Favorable clinical outcome was observed in 26 (66.7%) patients, while 13 (33.3%) patients had treatment failure. Patients with small tumor volumes, low vital structure deformity indice [(TV/(BSV + CerV) and (TV + EV)/(BSV + CerV)], and long distance of tumor to the central line were more likely to have favorable clinical outcome after GKRS. Significant prognostic value was with tumor shrinkage ratio (< 50%) were CV, CV/TV, TV/CerV, (TV + EV)/(BSV + CerV), and the distance of tumor to the central line. In cox regression, favorable clinical outcome was correlated with the Charlson comorbidity index and cochlear dosage (both p < 0.05). In multivariant analysis, tumor regression was highly correlated with the CV/TV ratio (p < 0.001).

Conclusions

The brainstem deformity ratio is likely a useful index to assess the clinical and tumor regression outcomes. Clinical outcomes are multifactorial and the tumor regression was highly correlated with the ratio of cystic components.

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Title: Using the deformity index of vital structures to predict outcome of patients with large vestibular schwannomas after Gamma Knife radiosurgery
Authors: Hao-Chun Chang
Weir Chiang You
Chiung-Chyi Shen
Ying Ju Chen
Ming-His Sun
Meei-Ling Sheu
Liang-Yi Pan
Jason Sheehan
Kuo-Chih Su
Hung-Chuan Pan
Publication date: 09-03-2023
Publisher: Springer US
Keywords: Vestibular Schwannoma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Vestibular Schwannoma
Published in: Journal of Neuro-Oncology / Issue 1/2023
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04280-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Using the deformity index of vital structures to predict outcome of patients with large vestibular schwannomas after Gamma Knife radiosurgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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